Healthcare Provider Details

I. General information

NPI: 1356707483
Provider Name (Legal Business Name): TSZ KIT KEVIN CHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TSZ KIT KEVIN CHAN MD

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2098 S MAIN ST
ANN ARBOR MI
48103-5827
US

IV. Provider business mailing address

3621 S STATE ST
ANN ARBOR MI
48108-1633
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-5780
  • Fax:
Mailing address:
  • Phone: 734-647-5299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301113635
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number4301113635
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: